title: Risk factors for febrile status epilepticus: a case-control study.
abstract: OBJECTIVE
  To identify risk factors for developing a first febrile status epilepticus (FSE) among children with a first febrile seizure (FS).
  
  
  METHODS
  Cases were children with a first FS that was FSE drawn from the Consequences of Prolonged Febrile Seizures in Childhood and Columbia cohorts. Controls were children with a first simple FS and separately, children with a first complex FS that was not FSE. Identical questionnaires were administered to family members of the 3 cohorts. Magnetic resonance imaging protocol and readings were consistent across cohorts, and seizure phenomenology was assessed by the same physicians. Risk factors were analyzed using logistic regression.
  
  
  RESULTS
  Compared with children with simple FS, FSE was associated with younger age, lower temperature, longer duration (1-24 hours) of recognized temperature before FS, female sex, structural temporal lobe abnormalities, and first-degree family history of FS. Compared with children with other complex FS, FSE was associated with low temperature and longer duration (1-24 hours) of temperature recognition before FS. Risk factors for complex FS that was not FSE were similar in magnitude to those for FSE but only younger age was significant.
  
  
  CONCLUSIONS
  Among children with a first FS, FSE appears to be due to a combination of lower seizure threshold (younger age and lower temperatures) and impaired regulation of seizure duration. Clinicians evaluating FS should be aware of these factors as many episodes of FSE go unnoticed. Further work is needed to develop strategies to prevent FSE.
authors.affiliation: Department of Epidemiology and GH Sergievsky Center, Columbia University, New York, NY. Electronic address: dch5@mail.cumc.columbia.edu.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Hesdorffer
authors.forename: Shlomo
authors.initials: S
authors.lastname: Shinnar
authors.forename: Darrell V
authors.initials: DV
authors.lastname: Lewis
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Nordli
authors.forename: John M
authors.initials: JM
authors.lastname: Pellock
authors.forename: Solomon L
authors.initials: SL
authors.lastname: Moshé
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Shinnar
authors.forename: Claire
authors.initials: C
authors.lastname: Litherland
authors.forename: Emilia
authors.initials: E
authors.lastname: Bagiella
authors.forename: L Matthew
authors.initials: LM
authors.lastname: Frank
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Bello
authors.forename: Stephen
authors.initials: S
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Masur
authors.forename: James
authors.initials: J
authors.lastname: Macfall
authors.forename: Shumei
authors.initials: S
authors.lastname: Sun
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D015331:Cohort Studies; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D003294:Seizures, Febrile / Q000150:complications* / Q000473:pathology; D013226:Status Epilepticus / Q000209:etiology* / Q000473:pathology; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Columbia Study; Columbia University Febrile Seizure Study; Consequences of Prolonged Febrile Seizures in Childhood; FEBSTAT; FS; FSE; Febrile seizure; Febrile status epilepticus; MRI; Magnetic resonance imaging